بررسی اثربخشی برنامه آموزش ذهن آگاهی مبتنی بر کاهش استرس بر کاهش علائم افسردگی و اضطراب بیماران مبتلا به کبد چرب غیرالکلی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 استادیار، گروه روانشناسی، دانشگاه پیام نور، تهران، ایران.

2 استاد، گروه روانشناسی، دانشگاه پیام نور، تهران، ایران.

3 کارشناس ارشد، گروه روانشناسی، دانشگاه پیام نور، تهران، ایران.

10.22123/chj.2021.218124.1434

چکیده

مقدمه: افسردگی و اضطراب در بیماران مبتلا به کبد چرب غیرالکلی شیوع بالایی دارد که باعث کاهش سلامت روانی و اختلال عملکرد آن‌ها می‌شود. با توجه به نقش قابل‌توجه عوامل روان‌شناختی در فرآیند درمان و بهبود بیماران، این پژوهش با هدف تعیین اثربخشی برنامه آموزش ذهن­آگاهی مبتنی بر کاهش استرس بر کاهش علائم افسردگی و اضطراب بیماران مبتلا به کبد چرب غیرالکلی انجام شد. 
مواد و روش‌ها: این کارآزمایی بالینی تصادفی شده در سال 1397 بر روی 30 نفر از بیماران مبتلا به کبد چرب غیرالکلی مراجعه‌کننده به کلینیک تخصصی غدیر شهرستان الیگودرز انجام شد. افراد به صورت تصادفی در دو گروه آزمایش و کنترل (هر گروه 15 نفر) قرار گرفتند. آموزش ذهن­آگاهی مبتنی بر کاهش استرس طی 8 جلسه‌ هفتگی (هر جلسه به مدت 45 تا 90 دقیقه) برای گروه آزمایش به اجرا در آمد. گروه کنترل مداخله‌ای دریافت نکردند. ابزار گردآوری داده‌ها مقیاس ارزیابی افسردگی، اضطراب و استرس بود. داده‌ها توسط آنالیز واریانس دو طرفه با اندازه‌گیری مکرر تجزیه و تحلیل شدند.
یافته‌ها: تفاوت معنی‌داری بین میانگین نمرات دو گروه آزمایش و کنترل در نمره افسردگی (001/0>p، 125/74 F= و 726/0=η ) و اضطراب (001/0>p، 015/158 F= و 849/0=η ) مشاهده شد. نمره افسردگی و اضطراب در گروه آزمایش پس از آموزش ذهن­آگاهی نسبت به گروه کنترل کاهش معنی­دار یافت.
نتیجه‌گیری: استفاده از برنامه آموزش ذهن­آگاهی مبتنی بر کاهش استرس به عنوان یک مداخله روان‌شناختی مؤثر و مکمل در بیماران مبتلا به کبد چرب غیرالکلی به منظور ارتقای سلامت روان آن‌ها پیشنهاد می‌گردد. 

کلیدواژه‌ها


عنوان مقاله [English]

Evaluation of the Effectiveness of Mindfulness-based Stress-reduction Training Program on Decreasing Depression and Anxiety Symptoms in Patients with Non-alcoholic Fatty liver

نویسندگان [English]

  • M Rahmanian 1
  • A Alipour 2
  • SH Mokhtari 3
1 Assistance Prof, Dept of Psychology, Payame Noor University, Tehran, Iran.
2 Prof, Dept of Psychology, Payame Noor University, Tehran, Iran.
3 MSc, Dept of Psychology, Payame Noor University, Tehran, Iran.
چکیده [English]

Introduction: Depression and anxiety are highly prevalent in patients with non-alcoholic fatty liver disease, reducing mental health and leading to dysfunction in various dimensions. Due to the significant role of psychological factors in the process of treatment and recovery of patients, this study was conducted to determine the effectiveness of the mindfulness-based stress-reduction training program on decreasing depression and anxiety symptoms in patients with non-alcoholic fatty liver.
Materials and Methods: This randomized clinical trial study was performed in 2018 on 30 patients with non-alcoholic fatty liver disease referred to Ghadir specialized clinic in Aligudarz city. Subjects were randomly divided into two experimental and control groups (15 people in each). Mindfulness-Based Stress-Reduction (MBSR) training was conducted for the experimental group during 8 weekly sessions (each lasting 45 to 90 minutes). The control group did not receive any intervention. The data collection tool was Depression, Anxiety, and Stress Scale (DASS). Data were analyzed using two-way repeated-measures ANOVA by SPSS software version 24.
Results: The results of two-way repeated-measures ANOVA showed a significant difference between the mean scores of the experimental and control groups in depression (p<0.001, F = 74.125 and η = 0.726) and anxiety (p<0.001, F = 015/158 and η = 0.849). Thus, the score of depression and anxiety of people with fatty liver in the experimental group after mindfulness training significantly decreased compared to the control group.
Conclusion: According to the obtained results, the mindfulness-based stress-reduction training program is recommended as an effective and complementary psychological intervention in patients with the non-alcoholic fatty liver to promote their mental health.

کلیدواژه‌ها [English]

  • depression
  • anxiety
  • Mindfulness
  • non-alcoholic fatty liver disease
  1. Ma J, Hwang SJ, Pedley A, Massaro JM, Hoffmann U, Chung RT, et al. Bi-directional analysis between fatty liver and cardiovascular disease risk factors  .JHEP 2017; 66(2): 390-7.
  2. Mitra S, De A, Chowdhury A. Epidemiology of non-alcoholic and alcoholic fatty liver diseases. TGH 2020; 5(16): 1-17.
  3. Labenz C, Huber Y, Kalliga E, Nagel M, Ruckes C, Straub BK, et al. Predictors of advanced fibrosis in non‐cirrhotic non‐alcoholic fatty liver disease in Germany. APTHEN 2018; 48(10): 1109-1116.‏
  4. Youssef NA, Abdelmalek MF, Binks M, Guy CD, Omenetti A, Smith AD, et al. Associations of depression, anxiety and antidepressants with histological severity of nonalcoholic fatty liver diseaseLiver International 2013; 33(7): 1062-1070.
  5. Lee JW, Park SH. Association between depression and nonalcoholic fatty liver disease: Contributions of insulin resistance and inflammation. JAD 2021; 1(278): 259-63.
  6. Yoo J, Johansson KH. Event-triggered model predictive control with a statistical learning. IEEE Trans Syst Man Cybern B Cybern 2019; 31(99): 1-11.
  7. Macavei B, Baban A, Dumitrascu DL. Psychological factors associated with NAFLD/NASH: a systematic review. Eur Rev Med Pharmacol Sci 2016; 20(24): 5081-97.
  8. Elwing JE, Lustman PJ, Wang HL, Clouse RE. Depression, anxiety, and nonalcoholic steatohepatitis. Psychosomatic Medicine 2006; 68(4): 563-569.‏
  9. Song Y, Lindquist R. Effects of mindfulness-based stress reduction on depression, anxiety, stress and mindfulness in Korean nursing students. NET 2015; 35(1): 86-90.
  10. Armstrong T. Backtalk: Keep religion out of mindfulness. PDK 2019; 101(4): 72.
  11. Gill LN, Renault R, Campbell E, Rainville P, Khoury B. Mindfulness induction and cognition: A systematic review and meta-analysis. COTR 2020; 84: 102991.
  12. Shapero BG, Greenberg J, Pedrelli P, de Jong M, Desbordes G. Mindfulness-Based Interventions in Psychiatry. Focus 2018; 16(1): 32-9.
  13. Mason J, Meal A, Shaw I, Adams GG. Outcomes of mindfulness-based stress reduction and mindfulness-based cognitive therapy in adults with diabetes: a systematic review. JDBT 2018; 13(2): 1-20.
  14. Guyot E, Baudry J, Hercberg S, Galan P, Kesse-Guyot E, Péneau S. Mindfulness Is Associated with the Metabolic Syndrome among Individuals with a Depressive Symptomatology. Nutrients 2018; 10(2): 232.
  15. Oraki M, Zare H, Hosseinzadeh Ghasemabad A. Compare the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) and Acceptance and Commitment Therapy (ACT) on Perceived Stress in Non-Alcoholic Fatty Liver Disease (NAFLD). RJMS 2020; 27(9): 32-40.[Persian]
  16. Smith PL, Little DR. Small is beautiful: In defense of the small-N design. Psychon Bull Rev 2018; 25(6): 2083-101.
  17. Lovibond SH, Lovibond PF.  Manual for the Depression Anxiety Stress Scales. 2nd ed. Sydney: Psychology Foundation. 1995: 125-32.
  18. Antony MM, Bieling PJ, Cox BJ, Enns MW, Swinson RP. Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological Assessment 1998; 10(2): 176.
  19. Henry JD, Crawford JR. The short‐form version of the Depression Anxiety Stress Scales (DASS‐21): Construct validity and normative data in a large non‐clinical sample. BJCP 2005; 44(2): 227-39.
  20. Samani S, Joukar B. A study on the reliability and validity of the short form of the depression anxiety stress scale (DASS-21). JSSH 2007; 26(3): 65-77. [Persian]
  21. Kabat-Zinn J. Wherever you go, there you are: Mindfulness meditation in everyday life. 1nd ed. New York, NY: Hyperion.1994: 104-132.
  22. Jajarmi M, Razavizadeh Tabadkan B, Vakili, Y. The Effectiveness of Mindfulness-based Cognitive Therapy (MBCT) on Depression and the Style of Ruminative Response in Women with Type 2 Diabetes Abstract. JWFS 2019; 12(43): 85-104. [Persian]
  23. Azadi MM, Manshaee G, Golparvar M. Comparing the Effectiveness of Mobile Social Network-Based Mindfulness Interventions with Acceptance and Commitment Therapy (ACT) and Mindfulness Therapy on Depression, Anxiety, Stress among Patients with Type 2 Diabetes. JDN 2019; 7(2): 775-792. [Persian]
  24. kamran A, havazadeh M, moghtadaei K, Abrahiemi A. The Effectiveness of Mindfulness Group Training on the Psychopathological Symptoms in Fat Women.  KRAP 2018; 19(3): 101-112. [Persian]
  25. Pearson S, Wills K, Woods M, Warnecke E. Effects of mindfulness on psychological distress and HbA 1c in people with diabetes. Mindfulness 2018; 9(5): 1615-1626.
  26. Hofmann SG, Gómez AF. Mindfulness-based interventions for anxiety and depression. Psychiatric Clinics 2017; 40(4): 739-749.
  27. Zulfqari M, Siroudi SH. The Effectiveness of Group Mindfulness Training on the Resilience and Anxiety of Mothers with Low Vision and Blind Children Referred to Sanandaj Health Centers. JECP 2019; 8(29): 77-89. [Persian]